ESF-8 PLANNING AND RESPONSE PROGRAM UPDATE THIS REPORT IS RELEASED (HAITI EARTHQUAKE) MAP KEY LINKS GOVERNMENT OF HAITI Government of Haiti website: www.haiti.org Government of Haiti Information Center INTERNATIONAL ORGANIZATIONS Pan American Health Organization RELIEFWEB UNICEF One Response World Food Programme Global Logistics Cluster Shelter Cluster IRIN US GOVERNMENT ORGANIZATIONS The Department of State U.S Embassy in Haiti State Dept.'s DipNote on Twitter State Dept. Background Note U.S. Agency for International Development OFDA USAID Country Profile CIA World Fact Book The Department of Defense US Southern Command The Department of Homeland Security U.S. Coast Guard The Department of Health and Human Services Centers for Disease Control and Prevention RELIEF ORGANIZATIONS AmeriCares American Red Cross CARE Charity Navigator Doctors Without Borders Mercy Corps OXFAM Partners in Health Save the Children Background Current Situation GoH Haiti Cluster Information Health Cluster Public Health Hospitals and Clinics Logistics AS OF: 1200 EST 25 MAY 2010 Water And Sanitation Food Shelters Protection Haiti in the Media THIS REPORT IS RELEASED ON A BI-WEEKLY BASIS. NEXT REPORT: 8 JUNE 10 Coordination Links

BACKGROUND A series of major earthquakes struck Haiti on 12 January in the area around the capital, Port-au-Prince. The strongest of these occurred at around 1700 hrs local time and was reported at 7 on the Richter scale. The earthquake is estimated to have killed 222,517 people and displaced more than 1.3 million people into spontaneous settlements and organized sites. 597,801 people have migrated from Port-au-Prince to outlying departments, with the majority, an estimated 162,509, going to Artibonite, and an estimated 160,000 persons to the border area with the Dominican Republic. The most affected cities are Port-au-Prince, Carrefour and Gressier (40-50% destroyed), Jacmel (50-60%) and Leogane (80-90%). Major damage had been reported to buildings, infrastructure, hospitals and schools. Communications are difficult: roads and bridges have been considerably damaged, as well as roads connecting rural areas to cities. According to a study by the Inter-American Development Bank (IDB), the cost of rebuilding Haiti's homes, schools, roads and other infrastructure could be nearly $14 billion. The United Nation multi-national response to this disaster has been organized into Clusters that are similar in construct, though not the same as Emergency Support Functions (ESF) in the U.S. National Response Framework. Residents take part in a protest near the national palace in PaP on 17 May 2010 Source: Reuters Residents take local public transportation near a provisional camp in PaP. Source: Eduardo Munoz/Reuters

OVERALL PH/MEDICAL ASSESSMENT SITUATION CURRENT ASSESSMENT On 12 May, the Acting U.N. Humanitarian Coordinator shared the draft GoH Settlement Strategy outline with Humanitarian Forum participants, encouraging humanitarian agencies and non-governmental organizations (NGOs) to provide feedback through the cluster system. The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) indicated that the current strategy document includes plans to shift from site-based provision of services to community-based services. OCHA also indicated that the strategy will focus on landlord– tenant issues, land tenure, and other related constraints. Haiti’s parliamentary elections were scheduled for February 2010. These elections, along with the presidential election, have been postponed until February 2011. Preparing for the elections will present a significant challenge, as voter registration records and land titles were lost or destroyed during the earthquake. In response to two diphtheria cases during the past week, the U.S. Centers for Disease Control and Prevention (CDC) and USAID have been working in partnership with U.N. World Health Organization (WHO)—including the Pan- American Health Organization (PAHO)—the U.N. Children’s Fund (UNICEF), and the GoH Ministry of Public Health and Population (MSPP) to develop a response protocol and communication strategy for diphtheria and other infectious diseases. During the past five years, Haiti experienced between 10 and 260 annual reported diphtheria cases. G A R B Not A Major Concern Currently Working But Inadequate Generally Ineffective Non-Functional or Destroyed Unknown MEDICAL OPERATIONS PRIMARY CARE MENTAL HEALTH MEDICAL WASTE COMMUNICATIONS MORTUARY AFFAIRS HOSPITALS SURGICAL EVACUATION MED SUPPLY VETERINARY BLOOD HAITI A G A A A G A G G G PUBLIC HEALTH PUBLIC HEALTH COMMUNICABLE DISEASES WATER SANITATION PPROTECTION VECTOR CONTROL SURVEILLANCE RODENT CONTROL FOOD WASTE\DEBRIS SEWAGE HAITI R A A A A A A A A B A OVERALL PH/MEDICAL ASSESSMENT USAID FACT SHEET #54 - 14 MAY 2010 USAID/OTI HAITI QUARTERLY REPORT JAN-MAR 2010 USAID FACT SHEET #55 - 21 MAY 2010

THE GOVERNMENT OF HAITI On 18 May, the International Organization for Migration (IOM), announced the creation of a new camp management operation, consisting of 12 teams that plan to liaise with local authorities and community leaders to improve the flow of information between affected populations and humanitarian actors. The teams’ mandate is to establish ties with the mayors of the seven municipalities in the greater Port-au-Prince area, officials from the Government of Haiti (GoH) Department of Civil Protection (DPC), and civil society leaders in order to develop a clear understanding of the specific needs and priorities of each municipality and to communicate that information through the humanitarian system to better meet beneficiary needs. During the week of 17 May, Haitian government officials and international donors continued to prepare and design a strategy for the relocation of displaced persons from the Champs de Mars spontaneous settlement to areas of origin in Port-au-Prince’s Fort National neighborhood. At a 19 May Humanitarian Forum meeting, representatives from the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) provided an update on the contingency planning and information collection process, which the GoH and partners are conducting in advance of the upcoming hurricane season. Following the DPC’s lead, OCHA has compiled contingency information from the humanitarian clusters and the U.N. Stabilization Mission in Haiti regarding available battalions and response capacity. On 19 May, five leading international financial institutions active in the Caribbean reinforced their commitment to ensuring long-term economic growth across the region, resilience to the global financial crisis and effective deployment of assistance for reconstruction efforts in Haiti by the signing of the Caribbean Joint Action Plan. Joint investment under the plan will concentrate on crucial economic sectors most impacted by the economic slowdown: finance, tourism and infrastructure. The institutions involved expect to commit up to USD 850 million in financial resources over a 2- 3 year period starting in 2010. Some aid agencies have criticized the government and the United Nations for being slow to set up alternative safer sites. John Holmes, the U.N. emergency relief coordinator, has said that the process faced several problems including there not being a proper land registry system (before the earthquake), legal documents being destroyed (relating to land title), the scarcity of suitable land for resettlement and the government’s hesitation to build large numbers if transitional shelters meant to last a few years (fearing that they’ll turn into permanent settlements). In a movement led by opposition leaders and activists one person was injured by gunfire in Port-au-Prince during new anti-government demonstrations. The incident occurred in the neighborhood of Bel Air when thousands of people from various parts of the city converged at the National Palace, chanting slogans against President René Préval. Police stood guard around the palace.

THE GOVERNMENT OF HAITI In response to two diphtheria cases, the U.S. Centers for Disease Control and Prevention (CDC) and USAID have been working in partnership with U.N. World Health Organization (WHO)—including the Pan-American Health Organization (PAHO)—the U.N. Children’s Fund (UNICEF), and the GoH Ministry of Public Health and Population (MSPP) to develop a response protocol and communication strategy for diphtheria and other infectious diseases, such as rabies. On 18 May, USAID staff met with representatives of CDC, MSPP, non-governmental organizations, PAHO, WHO, and other health staff to discuss protocol for a diphtheria public health response. Participants established a protocol for identifying and treating diphtheria, with current plans including launching an information campaign with CDC posters that feature photos and phone numbers regarding diphtheria symptoms and treatment. The first phase of the PAHO/WHO, UNICEF and the Ministry of Health and Population (MSPP) post-disaster vaccination program has been completed, resulting in the delivery of 880,000 vaccine doses, in 692 sites, to the most vulnerable children and adults throughout Haiti. This represents around 62% of the estimated target age group in the vaccinated settlements. The World Summit for the Future of Haiti, which is being held in the Dominican Republic on 2 June, seeks to create permanent ties of solidarity between the international community and Haiti and to spearhead the beginning of the reconstruction work. NOTES: Hurricane Preparedness is a very important focus for the next three months. It is especially important that secure housing is in place, be it in transitional shelters or relocation to less damaged housing, as well as outbreak preparedness, especially considering the recent diphtheria outbreaks. Another important focus area is economic stability and growth. Many articles have cited the need for creating jobs, advancing trade and the export industry, rebuilding the agriculture and other important industries, and extending temporary protective status in countries such as the United States due to the surge in remittances. Diaspora bonds have also been suggested by some, including World Bank representatives. It is also imperative that hurdles are overcome and peace and trust is obtained so that credible elections may be held. USAID FACT SHEET #55 – 21 MAY 2010 PAHO/WHO SIT REP ON HEALTH ACTIVITIES - 18 MAY 2010 CDB, EIB, IFC ARTICLE - RELIEFWEB 19 MAY 2010 ALERTNET ARTICLE - RELIEFWEB 19 MAY 2010 GOVT DOMINICAN REPUBLIC ARTICLE - RELIEFWEB 16 MAY 2010 ALTERPRESSE ARTICLE - RELIEFWEB 18 MAY 2010

CLUSTER INFORMATION (AS OF 19 MAY 2010) CONTACT LIST BY CLUSTER 3W GENERAL CONTACT LIST CLUSTER COORDINATOR CONTACT LIST 6 6 6

CLUSTER MEETING SCHEDULE 24-29 MAY 2010 ONE RESPONE – CLUSTER MTG SCEDULE 7 7 7

CLUSTER MEETING SCHEDULE 24-29 MAY 2010 ONE RESPONE – CLUSTER MTG SCEDULE 8 8 8

PUBLIC HEALTH The Ministry of Public Health and Population has launched its website: www.mspp.gouv.ht and is requesting all NGOs working in the health sector to register online. UN Agencies and Haitian Health authorities are carrying out an emergency vaccination campaign after a diphtheria outbreak in PaP. About 2,000 people thought to have been exposed to the diphtheria bacterium are being specifically targeted in the vaccination campaign, carried out by more than 80 vaccinators. In response to two diphtheria cases during the past week, the CDC and USAID have been working in partnership with WHO, PAHO and UNICEF and the MSPP to develop a response protocol and communication strategy for diphtheria and other infectious diseases, such as rabies. Current plans include an information campaign with CDC posters that feature photos and phone numbers regarding diphtheria symptoms and treatment. Health partners are also assembling binders for settlement sites that include images of different types of pathogens, how to identify diseases, and appropriate treatment. Vaccination Week of the Americas ended on 7 May. About 60,000 children under 5 years in border areas of the south, east, and west regions were targeted. They were vaccinated against diphtheria, tetanus, measles, whooping cough, polio and rubella. The first round of the national post-disaster vaccination program has also ended. PAHO reported reaching approximately 880,000 people at 692 spontaneous settlements through phase one of a vaccination campaign that began shortly after the earthquake and continued through mid-May. As of 1 May, an 82% coverage rate was registered. The second round will take place in June. NOTES: There is a need for family planning and vaccination services in sites with displaced people. During the past five years, Haiti experienced between 10 and 260 annual reported diphtheria cases. Surveillance systems should be prepared for other infectious diseases. USAID FACT SHEET #55- 21 MAY 2010 OCHA Humanitarian Bulletin #3- 21 MAY 2010 9 9 9

PUBLIC HEALTH (CONT) The number and percentages of reported diseases have changed little in recent weeks, according to USAID health staff. At 9.6 percent of reported diseases, acute respiratory infection remained the most commonly reported illness during weeks 5 through 18 after the earthquake, followed by suspected malaria cases (4.5 percent), watery diarrhea (4.4 percent), fever of unknown origin (4.4 percent), suspected typhoid (.7 percent), and bloody diarrhea (.5 percent). PAHO/WHO has released a comprehensive report on health-related activities since January’s earthquake, available here. According to USAID health officers, approximately 1 million long-lasting insecticide-treated mosquito nets are in the pipeline or in Haiti, and health partners had distributed approximately 112,000 nets as of May 19. APAN: http://biosurveillance.typepad.com/haiti_operational_biosurv/2010/02/haiti-epidemic-advisory-system-heas-sitrep-updated-20-feb.html PAHO and other aid organisations are starting a survey of 200 spontaneous settlements to help identify gaps in primary health care coverage. EU fact sheet) NOTE: As of 2008, 75% of the population had no access to any kind of health care. There was only one doctor for every 3,000 citizens, with private hospitals charging fees that put medical care out of reach for everyone but the wealthy. Sufficient plans will have to be made to ensure ongoing health care services for those unable to afford them. USAID Fact Sheet #55- 21 MAY 2010 USAID FACT SHEET #48 3-APRIL 2010 10 10 10

HOSPITALS AND CLINICS As expected, the number of earthquake-trauma cases is diminishing. However, earthquake victims continue to need post-operative and rehabilitative care, physiotherapy as well as psychological counseling. In addition, the population at large needs obstetric, pediatric, and trauma care. Logistics remains a key issue. There remains a lack of efficient resource tracking at the hospitals and clinics due to the fact that many are ad hoc constructs. When considering this and the fact the infrastructure is contracting, the medical infrastructure in Port-au-Prince is becoming more sensitive to abrupt changes in patient flow, and it portends a high probability of losing control in the context of an outbreak response during the coming rainy season. As of 24 March, 1,000 - 2,000 patients have been seen daily by basic health care units (BHCU), hospitals, and integrated mobile health clinics. The BHCUs and the mobile health clinics are increasingly engaged in disseminating key community health awareness messages to people while they await treatment. More comprehensive health care planning is needed for maternal health, family planning, people living with HIV/AIDS and people infected with TB. IFRC OPERATIONS UPDATE NO. 11 – 31 MAR 2010 MANAGEMENT SCIENCES FOR HEALTH REPROT 31 MARCH 2010 11 11

HOSPITALS AND CLINICS Sources within the Red Cross Red Crescent are indicating that some institutions have begun charging patients in hospitals although the Government of Haiti decided to wait until July to reinstate mandatory charges for medical services. A health center in Anse a Pitre which experienced an influx of IDPs is currently being supported by the NGO Battery Relief Agency (BRA) which is based in Dominican Republic. BRA will support the center in its maternal ward by placing gynecologists and surgical capacity in the center for complicated deliveries. Going forward, there will be a need to support the health center and build capacity because many women are crossing the border to deliver their babies.  According to PAHO, ensuring continuity of health services in hospitals and clinics is being addressed through provision of generators, tents, HTH drums, and fuel in the event of excessive flooding or road closures. NOTE: The reinstatement of a user pay system places pressure on the affected population as well as NGOs which are not charging for services, and consequently are inundated with persons seeking assistance. Methods to handle accountability and regulation should be discussed between GOH, NGOs and other stakeholders. IFRC OPS UPDATE - 21 MAY 10 PAHO/WHO SIT REP - 18 MAY 10 12 12

HOSPITALS AND CLINICS (CONT) The Japanese Red Cross Society which has been operating a Basic Health Care Unit in Automeca will move to Leogane. The German Red Cross Hospital continues to be active in Carrefour providing essential health care services free of charge. Plans for the hospital to move to a transitional space have been put on hold as the current premises are weathering the initial part of the rainy season. In Leogane, where access to health services or health centers is extremely limited, temporary field hospitals have been set up through Médecins Sans Frontières (Switzerland), the Cuban Brigades and an American NGO.  PAHO/WHO has installed containers in Léogâne and made plans for two health centers.  Plans for the reconstruction of a semi-private hospital (Cardinal Leger & Sanatorium de Siguenau) are underway.  In Grand Goave, PAHO/WHO has cleared out rubble and reconstructed 3 Health Centers - Meyer, Dufour and Dano - in collaboration with MDM Switzerland.  IFRC OPS UPDATE - 21 MAY 10 PAHO/WHO SIT REP - 18 MAY 10 13 13

MEDICAL LOGISTICS The current DAT stock of 173 vials in the national PROMESS warehouse is sufficient to treat between 10 and 100 cases of diphtheria, depending on severity, and additional stocks are en route to Haiti, according to national health authorities. Health staff in Haiti continue to liaise with other countries regarding the possibility of importing additional DAT, if necessary. PROMESS and health partners have 2,100 rabies vaccines and 40 rabies immunoglobulin doses in Haiti, as well as 300 additional doses on order. Issues remain regarding pre-positioning stocks, including sufficient cold chain resources, transport, sustainability, and which hospitals should receive the supplies, according to health partners. The Health Cluster has designed contingency plans for the rainy season which include an inventory for health activities undertaken by Health Cluster partners. Supplies in Port-au-Prince and surrounding areas have been identified for reproductive health, preventative medicines such as vaccines, treatment of acute malnutrition, and clean drinking water. In Jacmel, to strengthen contingency planning, Département Sanitaire du Sud Est (DSSE) has requested support in prepositioning drugs and supplies in strategic locations. As a short-term solution, ACDI/VOCA has put its three warehouses at the disposal of the DSSE to help stockpile essential drugs and supplies, placed in Cote de Fer, Thiotte and Belle Anse. International donations of blood will still be needed until the MSPP National Blood Safety Program is fully re-established. PAHO/WHO is now working with the MSPP and other partners to seek funds and international support to build new premises for the National Center for Transfusions.  A website providing procedures for therapeutic classification and access order and payment forms can be accessed at www.paho.org/promess and is available in both French and English.  PAHO/WHO SIT REP -18 MAY 10 USAID FACT SHEET #55 – 21 MAY 10 14

LIST OF CUSTOMS BROKERS LOGISTICS LIST OF CUSTOMS BROKERS LIST OF CUSTOMS BROKERS PAP

OVERVIEW OF DELIVERIES LOGISTICS OVERVIEW OF DELIVERIES LogCluster Delivery Overview 21 MAY 2010

WATER, SANITATION, AND HYGIENE (WASH) An increasing number of settlements are beginning to suffer from the adverse affects of continued rains. Settlements, such as Automeca, where drainage systems have been developed, have been better able to withstand the rains to date than settlements that have been formed in fields, but have either not received assistance or lack the capacity to reinforce the settlement’s drainage capacity. As heavy rains have started, Cluster agencies have undertaken efforts regarding mitigation works with the CCCM cluster in 100 identified vulnerable camps to reduce the risk of diarrhoeal disease outbreak. There are, as of yet, no reported outbreaks. Approximately 4,200 m3 of chlorinated water is being delivered on a daily basis. A working group has been set up to collect data, map kiosks and network systems for the ‘’beyond water trucking’’ strategy. As the subsidies for the delivery of free Reverse Osmosis (RO) treated water to kiosks has already been decreased, there will be a phase-out of subsidies. Until the end of the month, a price of 2 Gourd/5 gallons will be enforced. At the end of May, market price of water will be reinstated. Oxfam GB is undertaking a household survey to look at the impact of price rises through their livelihoods programme. With the phasing out and transition of the Emergency Response Units to the in-country structure as of 15 May, responsibility for the implementation of water and sanitation (“watsan”) activities has been passed on to the IFRC and Partner National Societies, who will work with the HRCS to continue to provide water via trucking to vulnerable settlements and improve and maintain available sanitation facilities. NOTES: Emphasis must be placed on the establishment of adequate drainage systems in all camps as the grounds become saturated with water and risk of flooding and sanitation issues increases. The ability to buy water once market prices are re-instated must be monitored closely to ensure that people are getting the water they need. PAHO/WHO SIT REP -18 MAY 10 UNICEF UPDATE - 14 May 10 IFRC OPS UPDATE - 21 MAY 10

WATER, SANITATION, AND HYGIENE (CONT) In May, WHO/PAHO began working with the WASH Cluster, SMCRS, DINEPA, and World Vision, to coordinate plans for emergency liquid waste containment and treatment at the TMD waste disposal site. The site only has capacity to manage solid waste, but since the earthquake, it has taken significant amounts of liquid waste from Port- au-Prince.  Key objectives of the project include preventing the spread of liquid waste and reducing risk to the local population through separation of harmful solid and liquid waste.  Partners in the De-sludging Working Group are awaiting a possible decision by UNOPS to take on the “Desludging Fleet Management Project”, essential for emptying the pits of toilets. 18 schools have received water tanks and latrines for a total of over 12,820 children. 30 additional school sites have been evaluated. In partnership with MSPP and DINEPA, a general framework of monitoring water quality has been developed.  A key objective has been to achieve proper chlorination for 50 DINEPA trucks temporarily supplying water to public facilities. Efforts to recruit and train attendants at filling stations are ongoing.   Technischen Hilfwerks (THW), a German NGO, is working with PAHO/WHO to conduct water analyses. Raw water first analysis has been conducted followed by a raw water routine monitoring for main chemicals. PAHO/WHO SIT REP -18 MAY 10 UNICEF UPDATE - 14 May 10 IFRC OPS UPDATE - 21 MAY 10

EMERGENCY FOOD ASSISTANCE AND FOOD SECURITY The International Fund for Agricultural Development (IFAD) has provided a $2.5 million grant – $2 million of which was provided by the Swedish government – to the Inter- American Institute for Cooperation on Agriculture (IICA) for a locally-managed 18-month program designed to create jobs and ensure food security for the Haitian countryside. The Haiti Post-Earthquake Support Programme for Food Security and Employment Generation in Affected Rural Areas is slated to repair some 13 irrigation systems, rebuild approximately 12km of rural roads, help build 300 community & family gardens, & provide around 9,000 households with seeds & tools. According to IFAD officials, the project, being implemented by local women's groups & community organizations, will also help build social capital by offering over 250 training courses on marketing, agricultural production, gender issues & organization building. French/Finnish and Benelux ERU teams wound down their distribution activities and left Haiti on 15 May, while the Mexican and Colombian Red Cross emergency relief teams have completed their respective distributions of supplemental food items. The IFRC relief team will integrate new relief delegates with national staff & volunteers, & in partnership with the HRCS, will continue to provide these teams with learning opportunities & on the job experience contributing to the national capacity to respond quickly to the needs of the affected population. The WFP is increasingly focused on planning, preparation & prepositioning for the rainy & hurricane seasons. Food is being pre- positioned throughout the country allowing for WFP & its partners to continue reaching the most vulnerable in remote areas. After providing emergency food rations to 3.5 million people in the months following the earthquake, the WFP is now transitioning to support recovery efforts through long-term food security & investments in human capital. Heifer International has begun distribution of resources in communities with existing projects in hope that backyard vegetable gardens & fast- producing small animal species such as pigs, fish & poultry will contribute to food security. Additionally, work has begun to help strengthen local grassroots organizations so they will be better prepared to respond to future disasters. Monsanto donated $4 million of seeds to Haiti. The Haitian Ministry of Agriculture has approved the donation, ensuring the selected seeds are appropriate for Haitian growing conditions & farming practices. http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/MUMA-85P2BU-full_report.pdf/$File/full_report.pdf http://www.reliefweb.int/rw/rwb.nsf/db900sid/CJUE-85NGE7?OpenDocument&emid=EQ-2010-000009-HTI http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/VDUX-85MLEY-full_report.pdf/$File/full_report.pdf http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/MYAI-85L2JW-full_report.pdf/$File/full_report.pdf http://www.reliefweb.int/rw/rwb.nsf/db900sid/SNAA-85J7JK?OpenDocument&emid=EQ-2010-000009-HTI http://www.reliefweb.int/rw/rwb.nsf/db900sid/SNAA-85J8E2?OpenDocument&emid=EQ-2010-000009-HTI IFRC OPERATIONS UPDATE 8 – 21 MAY 10 IFAD – 21 MAY 10 ACT SIT REP # 15 – 20 MAY 10 PAHO/WHO SIT REP – 18 MAY 10 HEIFER ITTERNATIONAL – 7 MAY 10 VOA – 15 MAY 10

NUTRITION Infant children are among the most vulnerable in Haiti. Studies suggest poor nutrition early in life can lead to chronic diseases later. Malnourished infants are also very susceptible to diarrhea, measles & other diseases that can turn fatal. Nutrition experts are increasingly concerned about newborns living in tent cities. Poor child nutrition in Haiti was common before the earthquake. “Haiti had a relatively low exclusive & immediate breast feeding rate prior to the earthquake,” said Kathryn Bolles of Save the Children. The Haitian government and international NGOs have created what is known as the baby tent. The goal is to encourage and assist more mothers to breast feed their children. Some Haitian mothers are afraid to breastfeed their children after the earthquake because they fear that their milk had been damaged by the earthquake. A new nutritional survey was carried out in affected areas from 24 April to the end of May, organized by UNICEF & the MSPP, with the participation of CDC, NGOs working on those areas and the collaboration of the WFP & PAHO/WHO. An agreement signed between UNICEF & International Medical Corp will facilitate the provision of minimum nutrition packages to 176,000 people living in the areas most affected by the earthquake: PaP metropolitan area, Petit & Grand Goâve, & Miragoâne departments. The package will support mothers to continue to breast feed exclusively for 6 months, ensure supplementation of multi micronutrients & de-worming in the first years of life, & detect & treat early on cases of acute malnutrition in children under 5. http://www.reliefweb.int/rw/rwb.nsf/db900sid/SNAA-85N9AV?OpenDocument&emid=EQ-2010-000009-HTI http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/MYAI-85L2JW-full_report.pdf/$File/full_report.pdf http://www.reliefweb.int/rw/RWFiles2010.nsf/FilesByRWDocUnidFilename/MUMA-85J9VZ-full_report.pdf/$File/full_report.pdf NOTES: Continued support of breastfeeding is needed, especially in camp settings for vulnerable groups. The efforts should include an educational component to ensure that mothers understand the importance of exclusive breastfeeding for the first 6 months. VOA – 18 MAY 10 PAHO/WHO SIT REP – 18 MAY 10 UNICEF UPDATE – 14 MAY 10

SHELTERS & NON FOOD ITEMS With high coverage of emergency shelter material, gap identification and specific targeted distribution is now the priority of responding humanitarian agencies whilst construction of transitional shelter increases. Gaps and Constraints Identified Continued uncertainty regarding available land and associated tenure issues. It remains that only one of the 3 sites identified by the government have been declared as available via eminent domain provisions. The continuing increase in both number of camps and the size of existing camps is providing challenges to implementing agencies. Anecdotal evidence suggests that a reasonable percentage of these increases are persons not directly affected by the earthquake. New occupants may come from existing economically challenged areas as they look for support. On May 18, the International Organization for Migration (IOM), the Camp Coordination and Camp Management Cluster lead, announced the creation of a new camp management operation, consisting of 12 teams that plan to liaise with local authorities and community leaders to improve the flow of information between affected populations and humanitarian actors. The teams’ mandate is to establish ties with the mayors of the seven municipalities in the greater Port-au-Prince area, officials from the Government of Haiti (GoH) Department of Civil Protection (DPC), and civil society leaders in order to develop a clear understanding of the specific needs and priorities of each municipality and to communicate that information through the humanitarian system to better meet beneficiary needs. During the week of May 17, Haitian government officials and international donors continued to prepare and design a strategy for the relocation of displaced persons from the Champs de Mars spontaneous settlement to areas of origin in Port-au-Prince’s Fort National neighborhood. A public messaging campaign remains ongoing in affected areas, with posters describing safe building practices and instructions for weatherizing existing emergency shelters for the rainy season. IOM is currently screening the messages in settlements. According to recent news articles there is some concern that if better housing is not available TB and typhoid have potential to become major problems. http://www.reliefweb.int/rw/rwb.nsf/db900sid/MUMA-8329KW/$File/full_report.pdf https://www.cimicweb.org/cmo/haiti/Crisis%20Documents/Shelter%20Cluster/100225_sitrep_ShelterNFIs_22.pdf http://campaign.constantcontact.com/render?v=0015_lm2NH4ZFKX11qSq-oAD0e3QF9c9DeJNEBka7M2dBMDMpQJpDBHea78HO2oUMk8eQA43_oZllfbgt1X0zdsoTQZv9wNbCSZSlVveMXmebusisC_u8QAlkhw6Mf_4tJFWu-I15bX90c= NOTES: Ensuring the people have shelter that is more protective then the emergency shelter needs to be a priority. This will help prevent the spread of disease . Working to help families that were not displaced by the earthquake meet t there needs without moving to the camps may help with overcrowding problems. USAID SIT REP NO 55, 21 MAY 2010 USAID SIT REP 54, 17 MAY 2010 SHELTER CLUSTER SIT REP FOR 17 MAY 2010

PROTECTION MADRE spoke with rape victims and they identified the following needs  in particular, the survivors we spoke with noted the following issues, a number of which were confirmed by our own visits to the camps: lack of lighting; lack of private bathing facilities; lack of tents; and even for those with tents, utter lack of security (at least one survivor stated that her attacker had used a blade to cut the side of her tent to gain access); lack of a police presence (many survivors stated that police only patrolled the perimeter of the camps and were unwilling to enter the interior, particularly at night). MADRE also found that Sexual assault survivors interviewed spoke of widespread occurrence of transactional sex to obtain food aid cards, although each interviewee denied having engaged in transactional sex herself.  Because most of the camps were erected with little or no planning, patrolling the camps is an onerous task and poses safety issues even for officers. Police are unwilling to enter the camps because they fear the armed gangs who generally are active at night when, due to the lack of lighting, attackers are less likely to be seen or recognized. Medicins Sans Frontiers reported 68 cases of rape in the month of April at one of their clinics in Port-au-Prince.  Two complementary and integrated needs assessments will take place in the coming weeks. One will focus on children with a psychosocial component; the other on MHPSS of children and adults. A hotline, set up the first week of May, for http://www.reliefweb.int/rw/rwb.nsf/db900sid/VVOS-82LTSJ/$File/full_report.pdf NOTE: There needs to be an effort to help prevent gender based violence in the camps. This can be done by ensuring privacy for women and girls is available for bathing and having security patrols of the latrines. MADRE: POST EARTHQUAKE VIOLENCE AGAINST WOMEN REPORT UNICEF UPDATE FOR 15 MAY 2010

SAFETY AND SECURITY The largest political protest since the January earthquake against the proposed extension of political officials’ mandates took place in Port-au-Prince on the 10th May with some 2,000 demonstrators calling for President Rene Preval's resignation. Three people were injured by stray bullets. Haitian police used tear gas and warning shots to disperse protesters after some demonstrators robbed passersby and tried to crash through barricades around the national palace. UNICEF programs and Clusters are conducting contingency preparedness plans and interventions to mitigate the impact of the rains and the upcoming hurricane season. On 17 May OAS (Organization of American States) Secretary General José Miguel Insulza released a statement reporting the kidnapping of an OAS Pan American Development Foundation (PADF) employee and a PADF consultant. The kidnapping occurred on 10 May and the consultant was released unharmed on 14 May, but the PADF employee, a driver for the agency, was found dead on 15 May. Security continues to be a concern, particularly in camps, where there have been multiple reports of rape and violence against women and children. U.N. police and the Haitian National Police have set up stations in several camps to provide security and respond to reports of violence. Police patrol during the day; however, they will not begin night patrols until lights are installed in the camps. UNICEF HAITI EMERGENCY RESPONSE UPDATE - 14 MAY 2010 OAS STATEMENT - 17 MAY 2010 USAID/OTI HAITI QUARTERLY REPORT JAN-MAR 2010

CURRENT MEDIA COVERAGE OF HAITI NEWS AGENCY WITH LINKS STORY DESCRIPTION UN News Service Diphtheria cases in Haitian camp prompt UN-backed emergency vaccination - United Nations agencies are helping health authorities in Haiti carry out an emergency vaccination campaign after an outbreak of diphtheria in the capital, Port-au-Prince, a spokesperson with the world body said today. Cases of the disease were first reported on Saturday in Camp Batimat in Cité Soleil district, one of the settlements housing people displaced by the January earthquake. 18 MAY 2010 Haiti: UN agency funds job creation and food production project - The United Nations fund tasked with alleviating rural poverty today announced a $2.5 million grant in support of job creation and food production projects in areas of Haiti where survivors of the earthquake in January sought shelter after losing homes and livelihoods in the capital, Port-au-Prince. 21 MAY 2010 AP UN: Big questions on prisoner deaths at Haiti jail – The United Nations is investigating the shooting of dozens of prisoners during a jail riot in the chaotic days after Haiti's earthquake, a spokesman for the U.N. peacekeeping mission confirmed Saturday. 22 MAY 10 Supporters want ex-dictator in next Haiti election- A small group of red-and-black clad supporters carried pictures of ex-Haitian dictator Jean-Claude "Baby Doc" Duvalier on Saturday, calling for the ousted ruler to return and participate in post-quake presidential elections. 22 MAY 10 24 24 24

COORDINATION LINKS   All Partners Network (APAN) - was developed to foster communication, collaboration and situational awareness across the global community. Note: Site requires login. Global Disaster Alerts Coordination System (GDACS) - Provides near real-time alerts about natural disasters around the world and tools to facilitate response coordination, including media monitoring, map catalogues and Virtual On-Site Operations Coordination Centre (OSOCC). Note: Must have an account to get alerts. HARMONIEWeb provides an unclassified internet accessible environment for the exchange of information across the civil-government boundary associated with Stability, Security, Transition and Reconstruction Operations or Humanitarian Assistance and Disaster Relief. One Response – A collaborative inter-agency website designed to enhance humanitarian coordination within the cluster approach, and support the predictable exchange of information in emergencies at the country level. The website will support Clusters and OCHA fulfill their information management responsibilities as per existing IASC guidance. ReliefWeb – Premier site from humanitarian information, it is a UN Office for the Coordination of Humanitarian Affairs (OCHA) sponsored website that provides information to humanitarian relief organizations. The Civil Military Fusion Center is an information knowledge management organization focused o improving civil –military interaction, facilitating information sharing and enhancing situational awareness through the web portal.